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Understanding and Exploring Weight-Based Bias, Stigma, and Discrimination

비만에 대한 편견, 낙인, 차별 및 이에 대한 개선 방안

  • Kayoung Lee (Department of Family Medicine, Busan Paik Hospital, Inje University College of Medicine)
  • 이가영 (인제대학교 의과대학 부산백병원 가정의학과)
  • Received : 2023.01.02
  • Accepted : 2023.03.07
  • Published : 2023.06.30

Abstract

The importance of weight discrimination for people with obesity has been highlighted by research which has found that more than 40% of those living with obesity have experienced weight discrimination. Evidence suggests that weight bias among obese individuals puts their health at risk more than health issues caused by obesity itself. Although bias, stigma, and discrimination towards individuals living with obesity are factors that make it difficult for them to lose weight, weight bias and stigma among healthcare professionals are common, causing individuals living with obesity to avoid treatment and potentially exacerbating obesity-related health issues. The concept that one's own efforts matter contributes to stigma, discrimination, and bias. This issue will be more frequent among primary care providers treating individuals living with obesity; thus, it is important to acknowledge the issues of bias, stigma, and discrimination towards individuals living with obesity and to seek out solutions. In this review, I will discuss the concept of weight bias, stigma, and discrimination, the problems they cause, and seek solutions to weight prejudice, stigma, and discrimination.

Keywords

References

  1. Rubino F, Puhl RM, Cummings DE, et al. Joint international consensus statement for ending stigma of obesity. Nat Med 2020;26:485-97. https://doi.org/10.1038/s41591-020-0803-x
  2. Spahlholz J, Baer N, Konig HH, Riedel-Heller SG, Luck-Sikorski C. Obesity and discrimination- a systematic review and metaanalysis of observational studies. Obes Rev 2016;17:43-55. https://doi.org/10.1111/obr.12343
  3. Korea Disease Control and Prevention Agency. Korea Health Statistics 2020: Korea National Health and Nutrition Examination Survey (KNHANES VIII-2). Cheongju: Korea Disease Control and Prevention Agency; 2022.
  4. Tomiyama AJ, Carr D, Granberg EM, et al. How and why weight stigma drives the obesity 'epidemic' and harms health. BMC Med 2018;16:123.
  5. Lawrence BJ, Kerr D, Pollard CM, et al. Weight bias among health care professionals: a systematic review and meta-analysis. Obesity (Silver Spring) 2021;29:1802-12. https://doi.org/10.1002/oby.23266
  6. Sutin AR, Terracciano A. Perceived weight discrimination and obesity. PLoS One 2013;8:e70048.
  7. Schvey NA, Puhl RM, Brownell KD. The impact of weight stigma on caloric consumption. Obesity (Silver Spring) 2011;19:1957-62. https://doi.org/10.1038/oby.2011.204
  8. Jungnickel T, von Jan U, Engeli S, Albrecht UV. Exploring the weight bias of professionals working in the field of obesity with a mobile IAT: a pilot study. Ther Adv Endocrinol Metab 2022;13:20420188221098881.
  9. Washington RL. Childhood obesity: issues of weight bias. Prev Chronic Dis 2011;8:A94.
  10. Puhl RM, Himmelstein MS, Pearl RL. Weight stigma as a psychosocial contributor to obesity. Am Psychol 2020;75:274-89. https://doi.org/10.1037/amp0000538
  11. Weight stigma [Internet]. World Obesity Federation. [cited 2022 Dec 26]; Available from: https://www.worldobesity.org/whatwe-do/our-policy-priorities/weight-stigma
  12. Link BG, Phelan JC. Conceptualizing stigma. Annu Rev Soc 2001;27:363-85. https://doi.org/10.1146/annurev.soc.27.1.363
  13. Lillis J, Luoma JB, Levin ME, Hayes SC. Measuring weight selfstigma: the weight self-stigma questionnaire. Obesity (Silver Spring) 2010;18:971-6. https://doi.org/10.1038/oby.2009.353
  14. Lacroix E, Alberga A, Russell-Mathew S, McLaren L, von Ranson K. Weight bias: a systematic review of characteristics and psychometric properties of self-report questionnaires. Obes Facts 2017;10:223-37. https://doi.org/10.1159/000475716
  15. Kim EM, Lee K, Hwang KM, Kim JS, Park TJ. Reliability and validity of Korean version of questionnaire for weight bias measurement. Korean J Fam Med 2010;31:461-71. https://doi.org/10.4082/kjfm.2010.31.6.461
  16. Sabin JA, Marini M, Nosek BA. Implicit and explicit anti-fat bias among a large sample of medical doctors by BMI, race/ethnicity and gender. PLoS One 2012;7:e48448.
  17. Puhl RM, Andreyeva T, Brownell KD. Perceptions of weight discrimination: prevalence and comparison to race and gender discrimination in America. Int J Obes (Lond) 2008;32:992- 1000. https://doi.org/10.1038/ijo.2008.22
  18. Carr D, Friedman MA. Is obesity stigmatizing? Body weight, perceived discrimination, and psychological well-being in the United States. J Health Soc Behav 2005;46:244-59. https://doi.org/10.1177/002214650504600303
  19. Hansson LM, Naslund E, Rasmussen F. Perceived discrimination among men and women with normal weight and obesity. A population-based study from Sweden. Scand J Public Health 2010;38:587-96. https://doi.org/10.1177/1403494810372266
  20. Hatzenbuehler ML, Keyes KM, Hasin DS. Associations between perceived weight discrimination and the prevalence of psychiatric disorders in the general population. Obesity (Silver Spring) 2009;17:2033-9. https://doi.org/10.1038/oby.2009.131
  21. Sutin AR, Stephan Y, Terracciano A. Weight discrimination and risk of mortality. Psychol Sci 2015;26:1803-11. https://doi.org/10.1177/0956797615601103
  22. Pearl RL, Wadden TA, Hopkins CM, et al. Association between weight bias internalization and metabolic syndrome among treatment-seeking individuals with obesity. Obesity (Silver Spring) 2017;25:317-22. https://doi.org/10.1002/oby.21716
  23. Robinson E, Sutin AR. Parental perception of weight status and weight gain across childhood. Pediatrics 2016;137:e20153957.
  24. Phelan SM, Burgess DJ, Yeazel MW, Hellerstedt WL, Griffin JM, van Ryn M. Impact of weight bias and stigma on quality of care and outcomes for patients with obesity. Obes Rev 2015;16:319-26. https://doi.org/10.1111/obr.12266
  25. Alberga AS, Edache IY, Forhan M, Russell-Mayhew S. Weight bias and health care utilization: a scoping review. Prim Health Care Res Dev 2019;20:e116.